A handful of North American companies which see potential for vape-like devices to ease migraines and respiratory diseases such as asthma have a long road to convince health authorities and patients that their products can be the future of inhaled medication. Two companies, Qnovia and MIIST Therapeutics, have developed vape-like devices based on technology used in existing medical nebulisers, which turns liquid medications into a fine mist. Another company, Greentank, says it has developed a way to vaporise substances via a heating chip that addresses safety concerns with current vapes and may offer a better way to treat ailments like migraines. The companies and experts say inhalation can relieve pain in seconds, with fewer side effects than pills, but their ambitions to sell devices resembling vapes in the medical sphere, amid growing concerns about their health impacts, will be a tough task. For now, Qnovia and MIIST will launch their products initially as prescription-only nicotine replacement therapy (NRT) treatments, while Greentank is initially targeting the use of its heating chip in recreational cannabis and nicotine vapes. The companies ultimately aim to see their devices delivering a wide range of drugs and Douglas Dunlap, chief commercial officer at Greentank, cites migraine medication as an example. A common method of administering migraine treatment is via a pill, which takes up to an hour to kick in and can include symptoms such as vomiting and dizziness. “If we could shorten that, it would be a huge success for us,” said Dunlap, a former executive at vape gaint JUUL, adding vapes can deliver a hit within 60 seconds. Three billion people globally suffer from migraines, according to the World Health Organization. Hundreds of millions more have conditions like asthma or pulmonary diseases, treated with inhaled medications. Pharmaceutical company GSK alone generated almost 7 billion pounds ($8.9 billion) of revenue from general respiratory medicines for conditions such as asthma and pulmonary diseases in 2023. Health concerns Federico Buonocore, a professor focused on alternative pulmonary drug delivery at Kingston University in Britain, said existing inhaled drug delivery devices are clunky and difficult to operate, and so tend to be used wrongly. A vape-like design could solve such challenges, he said. Big Tobacco firms have already tried and failed to tap into this market, their efforts fraught by mistrust and opposition from health officials. Philip Morris International last year scrapped a goal to earn over $1 billion in annual revenue by 2025 from its wellness and healthcare unit, which includes a business making asthma inhalers. CEO Jacek Olczak said the company had been “too optimistic about how the external environment will accept… Big Tobacco” in industries outside of nicotine. An inhaled aspirin product developed by the unit was also deemed unsuccessful after a clinical trial last year. Virginia-based Qnovia and California-based MIIST are pharmaceutical firms and not associated with Big Tobacco, although some of their top executives came from that industry. Qnovia CEO Brian Quigley, a former boss of tobacco giant Altria, told Reuters the company plans to submit drug applications in the U.S. soon and the United Kingdom in 2026 for its device as an NRT, and launch a clinical trial in September. MIIST also needs to secure regulatory approvals. Its Phase 1 clinical trial found its device could ease cravings faster than other approved NRTs like patches and gums – notoriously ineffective in helping smokers quit. Toronto-based Greentank, which was founded in 2015 to make vaping hardware, will see the first U.S. cannabis vape using its technology launched in September by U.S. company Jaunty. Greentank is now looking for a pharmaceutical partner to support the development of its heating chip for medicine delivery. MIIST founder Dalton Signor told Reuters he hopes the company’s device could one day be used to administer drugs for things like pain and anxiety relief. However, he said a major challenge is ensuring devices like MIIST’s are not conflated with typical vapes – the subject of growing health concerns. Authorities like the World Health Organization say vapes can produce harmful chemicals like formaldehyde and heavy metals, and their long-term impacts are uncertain. Venture capital investor Catharine Dockery, CEO of Vice Ventures, said her firm backed Qnovia because its nebuliser technology does not use heat, a process that can result in harmful emissions. Greentank’s device does use heat – a fact that also means some drugs may not work with it. Dunlap said Greentank is in the early stages of trying to identify medicines that are suited to the technology, and testing shows its heating method does not result in any harmful emissions. But many may remain sceptical. Kingston University’s Buonocore researched the use of e-cigarettes as drug delivery devices. “The first thing everyone told me was: ‘It is wrong to use this device as a medical device’,” he said, adding that concerns included that it would be inappropriate to prescribe them to children. “Coming out of that stigma is going to be very difficult for the sector.” ($1 = 0.7867 pounds) —Emma Rumney, Reuters